Vertigo occurs when otoliths, or mineral crystals normally present in the vestibule of your inner, become displaced and migrate into the ear canals. When you move your head in a certain way, usually when you look up, the otoliths shift and cause a spinning sensation that can persist up to a minute. The crystals usually move back into the vestibule on their own, but this can take weeks or months. Certain exercises may hasten this process.
The Semont maneuver is a particle-repositioning exercise designed to help otoliths move back where they belong. Your doctor may assist you with this exercise as part of treatment. While seated, preferably on an exam table, move your head 45 degrees to the side of your unaffected ear. Then lie down quickly on your other side so that you are now looking up, with the top of your head inclined down toward the floor. Hold the position for three minutes to allow the crystals to move into the opening of the ear canal. Your doctor will then help you sit up again quickly and lie down on your other wide. Your nose will now be pointing toward the floor. After three minutes, the otoliths should move out of your ear canal and back into the vestibule.
The Epley maneuver is similar to the Semont maneuver, but it begins by turning your head toward the side of your affected ear. Your doctor will then tilt you backward until you are horizontal with your head inclined toward the floor. Turn your head the other way and roll onto your side in the direction of your unaffected ear. All this will probably prompt a spell of vertigo. Remain inclined until it passes, then sit up again. The otoliths should have moved back to their natural location in the vestibule of your ear. This exercise has a somewhat higher success rate than the Semont maneuver.
Brandt and Daroff Exercise
Repositioning the crystals does not work in approximately 20 percent of patients, notes the University of Maryland Medical Center Hearing and Balance Center. If this occurs, the Brandt and Daroff exercise can teach your brain to stop reacting to the otoliths with dizzy spells. This is a "compensation" exercise. Lie down quickly on your right side and turn your head so you are facing the ceiling. Hold the position for 30 seconds, then sit up again for 30 seconds. Now lie down on your left side with your head turned to the right. Again, you’ll find yourself looking at the ceiling. Hold the position for 30 seconds, then sit up again. Do this exercise five times approximately two to three times a day for three weeks. If there's no improvement, cut back to two repetitions, three to four times a week.
Never attempt these exercises without confirmation from your doctor that you do, in fact, suffer from benign paroxysmal positional vertigo, the most common cause of vertigo. If the root of your problem is something else, you may aggravate your condition. If you perform the maneuvers at home, make sure you have someone with you because they tend to prompt spells of dizziness. It’s best if you have someone to help you reposition yourself so you don’t fall or get hurt. If you have any neck problems, let your doctor know, as these exercises may not be appropriate for you.